Background: Stroke is the third leading cause of death worldwide and stroke survivors experience more severe long-term disability than any other diagnosis groups. Manual dexterity impairment often occurs in post-stroke patients resulting in decreased hand function and in difficulty to perform daily living activities.

Purpose: This study aimed to evaluate the recovery of manual dexterity after 3 months of rehabilitation in acute and subacute stroke patients admitted in Bujumbura National Reference Center for Physiotherapy and Rehabilitation Medicine. The present study examined also sociodemographic and clinical factors associated with this recovery.

Methods: Stroke patients aged 18 and over admitted to the centre no later than 6 months after stroke were enrolled. Patients should have sufficient cognitive, behavioral, and communicative abilities with a Mini Mental State Examination score ≥ 24/30. Manual dexterity was tested at the beginning of rehabilitation (T0) and 3 months after (T1) using the Box and Block Test (BBT). Other clinical factors such as pain in plegic upper limb, wrist and hand muscle spasticity, strength of the hand and finger muscles, degree of independence in daily living activities (DLA) were assessed. Comparison of the data collected at T0 and T1 was performed using paired student t test for quantitative variables and the chi-square (χ2) for categorical variables. Pearson and Spearman correlation coefficients were calculated to determine the association between manual dexterity recovery, sociodemographic and clinical factors.

Results: The sample included fifty-one patients (mean age of 56.03 ± 63 years old) with a predominance of ischemic stroke (62.75 %). The mean score of BBT in the affected hand showed a statistically significant difference (p < 0.01) between T0 (Mean score ± SD: 28.1 ± 21.99 cubes) and T1 (Mean score ± SD: 36.22 ± 20.71 cubes).  Also, a significant decrease of spasticity (p = 0.0007) and a hand muscle strength improvement (p = 0.003) were observed. However, pain in affected upper limb (p = 0.64) and independence in daily living activities (p = 0, 10) showed no significant change over the 3 months of rehabilitation. Bivariate analysis showed that improvement of muscle strength (r = 0.09, p < 0.03) and spasticity decrease (r = - 0.16, p = 0.02) contributed significantly in manual dexterity recovery. However, other factors such as pain (r = - 0.1, p = 0.38), independence in daily living (r = 0.06, p = 0.72), age (r = - 0.61, p = 0.07) and gender (p = 0.4, r = 0.86) showed no significant association with manual recovery.

Conclusions: This study showed that 3 months of rehabilitation can improve manual dexterity in acute and subacute stroke patients. The recovery of manual dexterity in acute and subacute stroke patients was not associated with sociodemographic factors such as age and gender.

Implications: Rehabilitation exercises to improve manual dexterity in acute and subacute stroke patients should take into account improvement of muscle strength and inhibition of spasticity.

Keywords: Stroke - Upper limb - Rehabilitation - Manual dexterity